Condoms pit bishops against health workers in Philippines

Thomas C. Fox
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Nov. 11, 2012
NCR Today

Perhaps you saw the Nov. 9th New York Times profile[1] of the Dr. Jose Fabella Memorial Hospital in Manila where a reporter recently found more than 170 women and nearly as many newborns sharing fewer than 100 bed and dozens more expectant mothers lining the street outside, some sleeping on the sidewalk while waiting to get in.

The women, most of whom cannot afford to give birth at a private hospital, move through a type of controlled chaos from the street, to the labor room, to the delivery room, to the maternity ward and back out the door, usually in less than 48 hours. “It’s a never-ending story, 24 hours a day, every day,” said Dr. Romeo Bituin, who added that the government-run maternity hospital was legally required to serve as a safety net for the poor. “We can’t reject patients. If we turn them away, where will they go?”

The women are allowed into the hospital only when they are ready to give birth. After the birth, they sleep two to a bed in the maternity ward. If they have a healthy delivery without complications, they are sent home after one day. ... The hospital averages about 60 deliveries a day in the summer and about 80 deliveries in a 24-hour period during the peak delivery season, September to December. ... The hospital charges $70 for a delivery. Women who cannot afford that pay whatever they can.

The hospital does offer family planning information, but budget constraints prevent it from giving patients contraceptives, said Dr. Esmeraldo Ilem, the facility’s head of family planning services. “Family planning in the Philippines is not about population control,” Dr. Ilem said. “It is a health intervention. We are focusing on women who are too young, too old, too poor or too sick to have babies but their situation does not allow them to stop.” ... That description could be applied to Jelly Galia, a 44-year-old with seven children who was in the main ward after her eighth child died shortly after birth the night before. ... Sitting on a bed surrounded by women nursing their newborns, Ms. Galia said she lived with her children in a slum. Her husband is an unemployed taxi driver, and her family has no income. ...“I don’t want to have any more babies,” she said, wiping tears from her eyes. “I would take the pills, but we don’t have money to buy those. We’ll try ‘control,’ ” she said, using the local term for abstinence.The United Nations has urged the Philippines to pass a bill that will allow the government to provide free contraceptives.

The United Nations is hoping the Philippine government soon passes family planning legislation held up for more than 14 years. The legislation would allow reproductive education and permit funds for family planning measures. A UN official last week said passing the law[2] would significantly reduce the maternal mortality rate, which is one of the highest in south-east Asia. But the bill has met strong opposition from the Catholic church. On Saturday, bishops led a rally of thousands of people urging the rejection of the Reproductive Health Bill. According to the government's 2011 Family Health Survey, the maternal mortality rate rose 36 percent to 221 deaths per 100,000 live births between 2006 and 2010.Many of those giving birth were girls between 15 and 19 years old, and most were from poor families.

Philippine President Benigno Aquino, a Catholic, is strongly backing the reproductive health bill before the Philippines Senate that aims to give poor couples free access to family planning methods, including contraceptives and condoms, and would require schools to teach sex education. Aquino says his conscience would not allow him to stand aside [3]on the bill, despite defying the church. But the Catholic Bishops Conference has vowed to oppose the bill, even though legislators have watered it down to appease the church, removing references to a two child per family policy.

Private polls show that about 68 per cent of 76 million Filipino Catholics favor the government distributing free contraceptives to those who want them.

Many economists say the Philippines must bring its birthrate down to get a grip on problems such as poverty and overburdened infrastructure, which have long bedeviled the country of 104 million people. The Philippines has one of Asia's highest birthrates, with some 25 births per 1,000 people every year. In the U.S., that rate is 13.7.